02/05/2026
I began working with this client in late 2023, shortly after opening my private practice. She was in her early 60s and had lived with severe eczema since age seven—more than five decades of chronic itching, inflammation, and discomfort.
Eczema (atopic dermatitis) is not a simple skin condition. Research shows it is driven by several overlapping factors:
• A weakened skin barrier (often genetic)
• An overactive immune response
• The itch–scratch cycle
• Imbalances in the skin microbiome
Most conventional treatment focuses on managing symptoms: topical steroids, antihistamines, immunosuppressants, and biologic medications.
Biologics like Dupixent can be helpful, but they block inflammatory immune messengers that also play beneficial roles in the body—especially in eye health. For some patients, side effects become a major issue.
✨ Her Story
When she came to see me, she was using Dupixent. Her eczema was somewhat controlled, but she still had frequent flares. More concerning, she had severe eye irritation, discharge, and repeated infections.
She was stuck in a cycle:
Stop medication → eczema flare → restart medication → eye problems return.
At the same time, she depended heavily on topical steroids. While sometimes necessary, long-term overuse increases the risk of skin dependence and withdrawal.
She felt frustrated and out of options. That’s when she decided to explore a functional medicine approach.
🌱 Looking at the Whole Picture
Her diet was already excellent—lots of vegetables, fruits, great proteins, healthy fats, and fiber. There was very little to “fix” there. Her existing labs looked great, too.
So, we went deeper. We focused on:
✔️ Strengthening her skin barrier
✔️ Optimizing key nutrients
✔️ Supporting gut health
✔️ Calming immune overactivity
Because research shows a strong gut–skin connection, we evaluated her gastrointestinal and digestive health.
Testing revealed:
• Microbiome imbalances
• Overgrowth of certain microbes
• Low levels of key anti-inflammatory bacteria
We created a plan using very specific targeted prebiotics, probiotics, and postbiotics, along with natural antimicrobial support.
🌾 A Gluten Connection
Her testing showed a strong immune reaction to gluten in her gut. I suggested a trial elimination, but she wasn’t ready. Because… bread. 😊 I get it.
Celiac disease was ruled out, so she didn’t feel urgency about making the change.
🔍 Reassessing the Plan
After several months, her eczema worsened again when she stopped medication. It became clear that our approach wasn’t working, so we reassessed. We decided to explore the role that food could be playing, if any.
Advanced food allergy and sensitivity testing in early 2025 showed:
• True immune reactions to gluten and yeast
• Multiple food sensitivities
• Signs that her liver was amplifying her immune response to gluten
Her body was sending a very clear message. Still, she hesitated. Because… bread. Again, I get it.
🌟 The Turning Point
Last month, after years of cycling between flares and medications, she finally decided to embrace going gluten-free.
Within three days:
✨ About 90% of her eczema lesions cleared
✨ Her itching disappeared completely
Three days.
When I checked in this week, she reported that her skin is continuing to improve. She still has some lingering eye symptoms from past medication use—but her eczema remains largely clear.
🧠 The Bigger Picture
This case is a reminder that chronic skin conditions are rarely “just skin problems.”
They often involve:
• Genetics
• Skin barrier integrity
• Immune regulation
• Gut health
• Food reactions
Medication can be helpful—and sometimes necessary—but it usually doesn’t address root causes.
In this case, identifying and removing a major immune trigger allowed her body to finally calm down after more than 50 years. I was actually stunned that it was that simple. It usually isn’t.
Sometimes, healing isn’t about adding something new. It’s about removing what doesn’t serve the body.
For my friends that want to go a little deeper and know more, check out my last two slides.
